{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:04:54Z","timestamp":1792022694563,"version":"4.4.0"},"reference-count":78,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,16]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Use of an irrigating external intracranial drainage system has been an active and promising area of investigation in adult patients with intraventricular hemorrhage, ventriculitis, and chronic subdural hematoma. The objective of this study was to report on the safety and feasibility of an irrigating external intracranial drainage system for use in children.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Retrospective chart review was undertaken of the medical records of children who required an irrigating external intracranial drain (EID) at two children\u2019s hospitals for clearance of infection or blood from the ventricular system or extra-axial space. Irrigation parameters, CSF study results, adverse events during and after the course of irrigation, and ventricular peritoneal shunt outcomes up to 3 months postoperatively were assessed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Twelve patients younger than 18 years of age were treated between September 2023 and May 2025. Four patients were younger than 1 year of age (mean \u00b1 SD 4.72 \u00b1 3.81 months), and 8 patients were between 4 and 18 years (mean 11.52 \u00b1 4.33 years). Four patients required intracranial drainage for ventriculitis, 1 for intraventricular hemorrhage, 4 for postoperative clearance of blood following hemispherectomy or tumor resection, and 3 for subdural hematomas. The mean duration of irrigation was 6.45 \u00b1 5.25 days. One patient had an adverse event during irrigation, which was a clinical seizure. Irrigation was stopped and the patient was treated with levetiracetam with no further seizures. This was the only patient who received irrigation using normal saline with vancomycin. All other patients received irrigation with lactated Ringer\u2019s solution without antibiotics. Seven patients had a ventriculoperitoneal shunt after treatment\u20145 of whom had a shunt on presentation\u2014of which 2 required revisions for valve replacement within 3 months. All patients with ventricular pathology had stable ventricular configuration on follow-up imaging.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The use of an irrigating EID has potential utility for clearance of intracranial purulence and blood products in children. This is the first published series to delineate the safety and feasibility of this system in a group of children, 4 of whom were infants younger than 1 year of age.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.9.peds25294","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:11Z","timestamp":1769083211000},"page":"254-261","source":"Crossref","is-referenced-by-count":2,"title":["Safety and feasibility of an irrigating external intracranial drain in children"],"prefix":"10.3171","volume":"37","author":[{"given":"Brandon","family":"Shin","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Division of Pediatric Neurosurgery, Children\u2019s Nebraska, University of Nebraska Medical Center, Omaha, Nebraska;"},{"name":"Kansas City University College of Osteopathic Medicine\u2013Joplin Campus, Joplin, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Davies","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Orange County, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Self","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Orange County, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin","family":"Salehi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Division of Pediatric Neurosurgery, Children\u2019s Nebraska, University of Nebraska Medical Center, Omaha, Nebraska;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenn","family":"Skar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Health Systems Science, Children\u2019s Nebraska, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell J.","family":"McCulloh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Health Systems Science, Children\u2019s Nebraska, University of Nebraska Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joffre","family":"Olaya","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Orange County, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Yengo-Kahn","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Orange County, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnett","family":"Klugh","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Division of Pediatric Neurosurgery, Children\u2019s Nebraska, University of Nebraska Medical Center, Omaha, Nebraska;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Loudon","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital of Orange County, Orange, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace Y.","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Division of Pediatric Neurosurgery, Children\u2019s Nebraska, University of Nebraska Medical Center, Omaha, Nebraska;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Curr Neurol Neurosci Rep","first-page":"24","article-title":"External ventricular drainage for intraventricular hemorrhage","volume":"12","author":"Dey M","year":"2012","unstructured":"Dey M, Jaffe J, Stadnik A, Awad IA. External ventricular drainage for intraventricular hemorrhage. Curr Neurol Neurosci Rep. 2012;12(1):24\u201333."},{"key":"b2","series-title":"World Neurosurg","first-page":"e771","article-title":"Effectiveness of a standardized external ventricular drain placement protocol for infection control","volume":"151","author":"Zakaria J","year":"2021","unstructured":"Zakaria J, Jusue-Torres I, Frazzetta J, Effectiveness of a standardized external ventricular drain placement protocol for infection control. World Neurosurg. 2021;151:e771\u2013e777."},{"issue":"2","key":"b3","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"157","article-title":"Comparison of two drainage systems on chronic subdural hematoma recurrence","volume":"84","author":"Takroni R","year":"2023","unstructured":"Takroni R, Zagzoog N, Patel N, Comparison of two drainage systems on chronic subdural hematoma recurrence. 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Neurosurg Rev. 2024;47(1):40."},{"issue":"3","key":"b6","series-title":"Brain Hemorrhages","first-page":"131","article-title":"Implementation of irrigating drainage systems after burr hole evacuation of bilateral subdural hematomas leads to reduction in postoperative pneumocephalus and improved brain re-expansion\u2013a case report","volume":"3","author":"Himstead AS","year":"2022","unstructured":"Himstead AS, Davies JL, Chan AY, Tran DK, Chen J, Vadera S. Implementation of irrigating drainage systems after burr hole evacuation of bilateral subdural hematomas leads to reduction in postoperative pneumocephalus and improved brain re-expansion\u2013a case report. 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